Provider Demographics
NPI:1386841922
Name:A GABY MED SERV INC
Entity Type:Organization
Organization Name:A GABY MED SERV INC
Other - Org Name:DR EDWIN COIMBRE OFFICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COIMBRE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-825-0643
Mailing Address - Street 1:PO BOX 1865
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-1865
Mailing Address - Country:US
Mailing Address - Phone:787-825-0643
Mailing Address - Fax:787-825-2352
Practice Address - Street 1:CALLE JOSE I QUINTON #65
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-825-0643
Practice Address - Fax:787-825-2352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8370174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE62985Medicare UPIN